• Title/Summary/Keyword: Emergency Departments

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Quality of Chest Pain According to Causal Diseases and Description of Chest Pain in Patients with Coronary Artery Diseases in Emergency Departments (응급실을 내원한 흉통 환자의 원인질환에 따른 흉통의 질 및 관상동맥질환자의 흉통 표현)

  • Cheon, Sun Hee;Choe, Myoung Ae
    • Journal of Korean Clinical Nursing Research
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    • v.14 no.3
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    • pp.61-72
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    • 2008
  • Purpose: The purpose was to identify quality of chest pain according to causal diseases and pain expression of patients with coronary artery diseases. Method: Participants were 1,964 patients with pain who visited the emergency department of A hospital from January to December 2006. Data were collected from nurses' and doctors' records as to causal disease, and quality and expression of chest pain. Results: Causal diseases were coronary artery diseases, non-specific chest pain, respiratory diseases, non-coronary artery heart diseases and digestive diseases in that order of frequency. Every disease except respiratory disease caused mostly dull and tract pain, but 63.7% of patients with coronary artery diseases complained of typical angina pain and 24.9% complained of atypical angina pain. Patients with coronary artery diseases mostly used word 'heaviness' in describing their dull pain, and 'squeezing' for tract pain. Both male and female patients who were diagnosed with coronary artery disease complained mostly frequently of dull pain and tract pain. Conclusion: The most common causal disease for patients with chest pain was coronary artery disease. Patients with other diseases also frequently complained of dull and tract pain, the same as patients with coronary artery diseases. A considerable number of patients complained various types of atypical angina pain in coronary artery diseases.

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The Relationship between Experience of Verbal Abuse, Compassion Fatigue, and Work Engagement in Emergency Nurses (응급실 간호사의 언어폭력경험과 공감피로 및 직무열의의 관계)

  • Kim, Hee Jun;Lee, Youngjin;Yoo, Moon Sook
    • Journal of Korean Academic Society of Home Health Care Nursing
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    • v.26 no.3
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    • pp.300-308
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    • 2019
  • Purpose: This study is a descriptive research study to identify the relationship between the experience of verbal abuse, compassion fatigue, and work engagement among nurses in the emergency unit. Methods: Study subjects were 107 nurses working in a university hospital in Gyeonggi-Do. The instruments used were a verbal abuse checklist, a subscale of the Professional Quality of Life Scale used to measure compassion fatigue, and the Utrecht Work Engagement Scale. The data were analyzed using the IBM SPSS version 22.0 program for independent t-test, one-way ANOVA, and Pearson's correlation coefficients. Results: Emergency nurses experienced more verbal abuse and compassion fatigue than nurses in other departments, and the level of work engagement was low. There was a positive correlation between experience of verbal abuse and compassion fatigue and a negative correlation between both of these variables and work engagement. Particularly, verbal abuse appeared in the order of nurses, patients & caregivers, and doctors. This means there were serious problems with communication with nurses. Conclusion: In order to reduce verbal abuse, it is necessary to establish a communication culture of mutual respect between nurses, medical staff, patients & caregivers. Moreover, a compassion fatigue management program is needed to reduce emotional fatigue.

Training and role of paramedics in Japan (일본 구급구명사의 양성 및 업무에 관한 고찰)

  • Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.2
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    • pp.137-145
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    • 2014
  • Purpose: The emergency medical service (EMS) system in Japan is similar to that in Korea. This study reviewed the development of paramedics who are major personnel in the respective EMS system of their country. Methods: We searched law for paramedics and publications in J-stage, MEDLINE and the webpage of Japan's Fire and Disaster Management Agency. Results: Paramedic training had started in Japan in 1991, and most paramedics were employed in fire departments. In Japan, ambulances belonging to fire department are staffed by a three-person unit, including at least one paramedic. Medical control advisory boards were established in all Japanese prefectures in 2003 with the purpose of upgrading the activities of ambulance personnel, including paramedics. The scope of paramedics' work has been widened owing to the continued efforts of medical control advisory boards. This allows them to perform invasive procedures including tracheal intubation, intravenous line placement, and epinephrine administration under medical control of a physician. Conclusion: As paramedics' responsibilities expand, further development of the paramedic role and an effective medical control advisory board system are imperative both Korea and Japan.

Unintentional Pharmaceutical Poisoning in the Emergency Department (응급실로 내원한 비의도적 의약품 중독)

  • Jo, Hyo Rim;Lee, Choung Ah;Park, Ju Ok;Hwang, Bo Na
    • Journal of The Korean Society of Clinical Toxicology
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    • v.16 no.2
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    • pp.116-123
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    • 2018
  • Purpose: The social environment of easy access to medicines and arbitrary personal decisions leading to overdose aggravate unintentional medicine poisoning. This study aimed to investigate the characteristics of patients who visited emergency departments with unintentional medicine poisoning and reasons for poisoning based on age group. Methods: We retrospectively collected patients who experienced unintentional medicine poisoning based on data from the national injury surveillance system between 2013 and 2016. Subjects were classified into three groups based on age (0-14 years, 15-64 years, and ${\geq}65\;years$). We identified sex, insurance, time of poisoning, place, alcohol co-ingestion, hospitalization, death, and reason for poisoning in each age group. Results: A total of 27,472 patients visited an emergency department with poisoning during the study period; 1,958 patients who experienced unintentional poisoning were enrolled in this study. Respiratory medicine was the most frequent medicine in those younger than 15 years of age, and sedatives and antipsychotic drugs were the most common in patients older than 15 years of age. In total, 35.1% of patients older than 65 years were hospitalized. The most common reasons for poisoning were careless storage of medicine in those younger than 15 years of age and overdose due to arbitrary decisions in those older than 15 years of age. Conclusion: Unintentional medicine poisoning has distinct characteristics based on age group, and strategies to prevent poisoning should be approached differently based on age.

Nurses' Image Perceived by Nursing and Health Allied College Students in Korea (간호.보건 계열 대학생이 지각하는 간호사 이미지)

  • Seo, Eun-Hui
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.4
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    • pp.610-616
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    • 2009
  • Purpose: The purpose of this study was to compare and analyze the nurses' image perceived by nursing and health allied college students in Korea. Method: The data was collected from October 15th to November 15th, 2004. Subjects were composed of 679 students in three-year Junior College. The data was analyzed by SPSS 12.0 PC+ Win. The difference of nurse' image among departments and locations of Junior College were analyzed by t-test, ANOVA and Tukey test. Result: The mean score of nurses' image 3.1 point of the total 5 point. Nurses' image is showed significantly difference according to the departments; the department of nursing (3.54), physical therapy (3.01), radiology (2.97), emergency medical technology (2.76) and clinical pathology (2.67). Nurses' image was significantly differed among the 4 domains according to 5 departments; 'the qualification of nurse', 'the role of nurse', 'the interpersonal relationship of nurse', 'the social participation of nurse'. Nurses' image formed through directly contacting with nurses' and seeing nurses' action (69.1%), watching nurse in TV drama (15.9%). Conclusion: It is considered that nursing and health allied college students were affected by inter-communications with nurses' more than by mass media.

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Regulation of Endoplasmic Reticulum Stress Response by the Immobilization Stress (부동스트레스에 의한 소포체스트레스반응 조절)

  • Kwon, Ki-Sang;Kwon, Young-Sook;Kim, Seung-Whan;Kim, Dong-Woon;Kwon, O-Yu
    • Journal of Life Science
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    • v.22 no.8
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    • pp.1132-1136
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    • 2012
  • Many kind of cell stresses induce gene expression of unfolded protein response (UPR)-associated factors. This study demonstrated that up- and down-regulation of gene expression of endoplasmic reticulum (ER) stress chaperones and ER stress sensors was induced by immobilization stress in the rat organs (adrenal gland, liver, lung, muscle). However, no statistically significant regulation was detected in the others (heart, spleen, thymus, kidney, testis). The results are the first to show that immobilization stress induces UPR associated gene expression, will help to explain immobilization stress-associated ER stress.

The Experiences of the Emergency Antidote Stock and Delivery Service by the Korean Poison Information Center (독극물정보센터 구축사업의 일환으로 시행한 전국단위 응급해독제 비축 및 배송경험)

  • Park, So Young;Oh, Bum Jin;Sohn, Chang Hwan;Jeong, Ru Bi;Lim, Kyoung Soo;Kim, Won;Ryoo, Seung Mok
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.9-18
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    • 2013
  • Purpose: Antidotes for toxicological emergencies can be life-saving. However, there is no nationwide stocking and delivery system for emergency antidotes in Korea. We report on a two-year experience of a nationwide stocking and delivery trial for emergency antidotes at emergency departments in Korea. Methods: An expert panel of clinical toxicologists reviewed and made a list of 15 stocked antidote. These antidotes were purchased or imported from other countries and delivered from 14 antidote stocking hospitals nationwide 24 hours per day, seven days per week. Results: From August 1, 2011 to April 30, 2013, 177 patients with acute poisoning, with a median age of 48.5 years, were administered emergency antidotes. The causes of poisoning were intentional in 52.0% and 88.0% were intentional as a suicide attempt. Regarding clinical severity, using the poisoning severity score, 40.7% of patients had severe to fatal poisoning and 39.0% had moderate poisoning according to clinical severity. The most frequent presenting symptom was neurologic deficit, such as altered mentality (62.7%). alerted mentality (62.7%). Emergency antidotes were administered as follows: methylene blue (49 cases), flumazenil (31), N-acetylcysteine (25), glucagon (17), 100% ethanol (15), cyanide antidote kit (12), anti-venin immunoglobulin (5), pyridoxine (4), hydroxocobalamine (2), and deferoxamine (1). The median time interval from antidote request to delivery at the patient's bedside was 95 minutes (interquartile range 58.8-125.8). Conclusion: Findings of this study demonstrated the possibility of successful operation of the nationwide system of emergency antidotes stocking and delivery in Korea.

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A Simple and Easy Method to Prevent Intravenous Fluid Heat Loss in Hypothermia (저체온 환자 치료에서 정맥주입 수액의 열손실을 막는 간단한 방법에 관한 고찰)

  • Lee, Sun Hwa;Choi, Yoon Hee;Lee, Dong Hoon
    • Journal of Trauma and Injury
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    • v.26 no.4
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    • pp.255-260
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    • 2013
  • Purpose: For the treat hypothermia patients, active warming might be needed. In most emergency departments, IV warm saline infusion is used for treatments. However, during IV warm saline infusion, heat loss from the warm saline may occur and aggravate hypothermia. Thus, in this study, we conducted an experiment on conserving heat loss from warm saline by using a simple method. Methods: Four insulation methods were used for this study. 1) wrapping the set tube for the administration of the IV fluid with a cotton bandage, 2) wrapping the set tube for the administration of the IV fluid with a cotton bandage with aluminum foil, 3) wrapping the warm saline bag and tube with a cotton bandage, and 4) wrapping the warm saline bag and tube with a cotton bandage with aluminum foil. Intravenous fluid was preheated to a temperature between $38-40^{\circ}C$. The temperatures of the saline bag temperature and the distal end of the IV administration set were measured every ten minutes for an hour. The infusion rate was 1000 cc/hr, and to obtain an accurate infusion rate, we used an infusion pump. Results: The mean initial temperature of the saline bag was $39.11^{\circ}C$. An hour later, the fluid temperature at the distal end of the fluid temperature ranged from $39.11^{\circ}C$ to $34.3^{\circ}C$. Without any insulation, the initial temperature of the pre-heated warm saline, $39^{\circ}$ had decreased to $34.8^{\circ}C$ after having been run through the 170-cm-long IV administration tube, and after 1-hour, the temperature was $29.63^{\circ}C$. As we expected, heat loss was prevented most by wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil. Conclusion: Wrapping both the saline bag and the IV administration set with a cotton bandage and aluminum foil can prevent heat loss during IV infusion in Emergency departments.

Triage Accuracy of Pediatric Patients using the Korean Triage and Acuity Scale in Emergency Departments (한국형응급환자분류도구를 적용한 응급실에서 소아 환자의 중증도 분류 정확성)

  • Moon, Sun-Hee;Shim, Jae Lan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.626-634
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    • 2018
  • This retrospective study investigates the accuracy of triage procedures for pediatric patients in emergency departments (EDs) using the Korean Triage and Acuity Scale (KTAS). The study includes 250 randomly selected initial nursing records and clinical outcomes of pediatric patients who visited one regional ED or a local ED from October 2016 to September 2017. The collected data were analyzed by a qualified expert to determine the true triage score. The accuracy of triage was defined as the agreement between the triage score of the emergency nurses (ENs) and the true triage score as determined by the expert. Based on expert comments, the cause of the triage error was analyzed and the KTAS score was compared with the discharge, length of stay (LOS), and medical cost. The results showed that the degree of agreement in the triage score between the experts and the ENs was excellent (weighted kappa=0.77). Among the causes of triage discordance, the most frequent was the incorrect application of vital signs to the KTAS algorithm criteria (n=13). Patients with high severity KTAS levels 1 and 2 were discharged less often (${\chi}=43.25$, p<0.001). There were significant differences in the length of stay (F=12.39, p<0.001) and cost (F=11.78, p<0.001) between KTAS scores when adjusting for age. The results of this study indicate that KTAS is highly accurate in EDs. Hence, the newly developed triage tool is becoming well established in Korea.

A Study on the Activation·Specification of 119 Rescue & Care in JeJu (제주도 119구조·구급대의 활성화 및 전문화 방안)

  • Koh, Jae-Moon;Kim, Tae-Min;Kim, Hyo-Sik;Lee, Young-A
    • The Korean Journal of Emergency Medical Services
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    • v.6 no.1
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    • pp.153-168
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    • 2002
  • Since 1992, conventional fire fighting businesses have been converted into a metropolitan autonomous fire fighting system to be ready for a variety of disasters. However, the corresponding investment has been overlapped due to the non-integration of businesses to prevent any potential disasters, and a series of collaborative systems have been not functioning so well. In the meantime, our fire fighting sector has been trying to set up its own clean and faithful position by abolishing any inconvenient system or outsourcing private sectors, and expanded its work scope from conventional fire fighting even to rescue and emergency works. While focusing on handling disaster, the fire fighting sector has been widely trusted and reliable throughtout our nation. Moreover, our fire fighting sector has secured nation wide mobile organizations, technical personnel by field, special equipments and independent communication network. In addition, the fire fighting sector has knowledges, expertise and capabilities required for managing disasters, while in charge of almost every disaster management works including fire, explosion, collapse, disaster and flood. It becomes an organization for comprehensive disaster management under an absolute national trust, which is based on the system for prevention, preparation and countermeasure against a variety of disasters. Thus, our fire fighting sector must make many efforts and try to modernize conventional education and training. The ways to facilitate rescue and emergency works may include the nurture of technical fire fighting personnel along with modernized equipments, the reinforcement of rescue and emergency education, the facilitation of operating civil defense corps, the facilitation of operating volunteer fire fighting corps, the better arrangement of 119 briefing room for public healthcare in provincial offices, the sterilization of rescue instruments and equipments the better repair education for emergency rescue member, the establishment of regional emergency assistant system and the expansion of fire fighting personnel and equipments. In terms of reinforcing the functions and services of rescue 119 and emergency corps, we must review the following considerations: Building up security system along with operational expansion, building up a system for emergency medical treatment, building up a comprehensive information management system for rescue and emergency, constructing a provincial safety museum and so forth. For the ways to better the works of rescue 119 we can review the following considerations : Improving the education for fire fighting training corps under Jeju Provincial Fire and Disaster Management Department, providing rescue members with more opportunities for clinical practices, enhancing the morale of rescue members, installing a comprehensive briefing room for emergency rescue members, building up medical networks along with reasonable policies for information service, operating the consulting system for rescue 119 and so on. If these requirements are met, it is expected that the fire fighting departments in Jeju province can cope with every accident and disaster a little more rapidly and quickly in compliance with local needs, so that they can keep their own position as a public fire fighting organization which may be trusted by the public.

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